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BRACHIAL PLEXUS 
• By: Syed Irshad Murtaza 
• Technologist CNPS AKUH Karachi 
• Date: 13-05-2014
What is the Brachial Plexus? 
• Introduction 
• A network of spinal nerves that originates in the 
back of the neck, extends through the axilla 
(armpit) and gives rise to nerves to the upper 
limb. 
• The brachial plexus is a network of nerve fibers, 
running from the spine, formed by the ventral 
(Anterior) rami of the lower four cervical and first 
thoracic nerve roots (C5-C8, T1).
Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)
Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)
Anatomy 
• Brachial Plexus proceeds through the neck, 
the axilla (armpit region), and into the arm. It 
is a network of nerves passing through the 
cervico-axillary canal to reach axilla and 
innervates brachium (upper arm), 
antebrachium (forearm) and hand.
Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)
Horns in the spinal Cord 
• In the spinal cord the gray matter is present inside 
and white matter I towards outside while in the 
brain this distribution is vice versa. 
• On cross section of the spinal cord gray matter in 
spinal cord presents butterfly like structure from 
which some projections like “Horns” are seen, 
termed as 
• Ventral/Anterior Horn (ventral/anterior/motor 
root centre (Efferent Nerve) 
• Lateral Horn (Preganglionic sympathetic neurons, 
• Dorsal/posterior Horn (dorsal/posterior/sensory 
root centre (Afferent Nerve)
Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)
Terms to define 
• Ganglion: collection of the nerve cell bodies is called 
ganglion. E.g Dorsal root ganglion (DRG) 
• Ramu (Pl: Rami) Spinal nerve when exits from the 
vertebrae , it divides into two branches termed as, 
• 1. ventral/anterior primary ramus 
• 2. dorsal/posterior primary ramus 
• Ventral/anterior ramus: it is the ventral division of 
spinal nerve outside the vertebrae, which supplies 
to the skin, muscles on anterior body. 
• Dorsal division supplies to the skin and muscles of 
the back.
RTDCB 
• Brachial plexus comprises of Root, Trunk, 
Division, Cord and peripheral Branches. 
• A mnemonic for remember the region of the 
brachial plexus is: 
• Real - Roots 
• Teenagers - Trunks 
• Drink - Divisions 
• Cold - Cords 
• Beer – Branches
Brachial Plexus
Anatomy of RTDCB 
• Roots: (lying between the anterior and middle 
scalene muscles), 
• Trunks: (found in the posterior triangle of the 
neck), 
• Divisions: (lay posterior/behind the clavicle), 
Cords: (found in axilla & named according to 
their relationship with axillary/brachial artery ) & 
• Branches: (the five main nerve fibers in the arm).
Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)
Formation of Roots & Trunk of the Brachial Plexus 
The roots of the brachial plexus come from 
branches of the spinal vertebrae C5-8 and T1. 
The cervical roots, C5 and C6, fuse together to 
form the Upper (Superior) trunk 
The cervical root C7 goes on to become 
the Middle trunk 
The cervical roots, C8 and T1, fuse together to 
form the Lower (Inferior) trunk
The Trunks & Divisions of the Brachial Plexus 
• There are three trunks of the brachial plexus that 
lie in the posterior neck triangle. 
• Each of the Trunks has its two divisions 
• Anterior Division 
• Posterior Division 
• (Anterior divisions of the upper, middle, and 
lower trunks 
• Posterior divisions of the upper, middle, and 
lower trunks) 
• These six Divisions further unite to form the 
Cords.
The Divisions & Cords of the Brachial Plexus 
• There are two divisions of the brachial plexus that 
lie posterior to the clavicle. These divisions go on 
to form the cords of the brachial plexus. 
• Anterior divisions of Upper and Middle Trunks go 
on to form the Lateral cord 
• All Posterior divisions go on to form 
the Posterior cord 
• The Anterior division of the Lower Trunk goes on 
to form the Medial Cord
The Cords and main Terminal (Peripheral) branches 
of Brachial Plexus 
• The cords of the brachial plexus divide and join 
together to form the five main nerve branches of 
the arm. 
• The Lateral cord divides to become 
the Musculocutaneous and Median Nerve 
Branches. 
• The Medial cord divides to become the Median and 
Ulnar Nerve Branches 
• The Posterior cord divides to become the Radial 
and Axillary Nerve Branches
Branches from direct roots 
• Dorsal scapular nerve-(c4-c5)- (levator 
scapulae, rhomboids) 
• Subclavian nerve(c5-c6)- (subclavian muscle 
• Long thoracic nerve(c5-c7)- serratus anterior 
muscle 
• Branch from trunk 
• Supra scapular nerve(c5-c6)- branch from 
upper trunk. 
• Supplies infra/supraspinatus
Branches and their Roots 
• There are five "terminal" branches and numerous other "pre-terminal" 
or "collateral" branches that leave the plexus at various 
points along its length. 
• Lateral cord-1) musculocutaneous nerve(c5-c7) 
2) lateral head of median nerve(c5-c7) 
• Medial cord-1) med.ant.thoracic nerve(c8-T1) 
2) med. Cut. Nerve of arm(c8-T1) 
3) med.cut. Nerve of forearm(c8-T1) 
4) ulnar nerve(c7-T1) 
5) med. Head of median nerve(c8-T1) 
• Posterior cord- 
1) subscapular nerve(upper, lower)(c5-c7) 
2) thoraco dorsal nerve(c5-c7) 
3) axillary nerve(c5-c6) 
4) radial nerve(c5-c8)
Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)
Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)
TTHHAANNKKSS

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Anatomy of Brachial Plexus (by Murtaza Syed AKUH Karachi)

  • 1. BRACHIAL PLEXUS • By: Syed Irshad Murtaza • Technologist CNPS AKUH Karachi • Date: 13-05-2014
  • 2. What is the Brachial Plexus? • Introduction • A network of spinal nerves that originates in the back of the neck, extends through the axilla (armpit) and gives rise to nerves to the upper limb. • The brachial plexus is a network of nerve fibers, running from the spine, formed by the ventral (Anterior) rami of the lower four cervical and first thoracic nerve roots (C5-C8, T1).
  • 5. Anatomy • Brachial Plexus proceeds through the neck, the axilla (armpit region), and into the arm. It is a network of nerves passing through the cervico-axillary canal to reach axilla and innervates brachium (upper arm), antebrachium (forearm) and hand.
  • 7. Horns in the spinal Cord • In the spinal cord the gray matter is present inside and white matter I towards outside while in the brain this distribution is vice versa. • On cross section of the spinal cord gray matter in spinal cord presents butterfly like structure from which some projections like “Horns” are seen, termed as • Ventral/Anterior Horn (ventral/anterior/motor root centre (Efferent Nerve) • Lateral Horn (Preganglionic sympathetic neurons, • Dorsal/posterior Horn (dorsal/posterior/sensory root centre (Afferent Nerve)
  • 9. Terms to define • Ganglion: collection of the nerve cell bodies is called ganglion. E.g Dorsal root ganglion (DRG) • Ramu (Pl: Rami) Spinal nerve when exits from the vertebrae , it divides into two branches termed as, • 1. ventral/anterior primary ramus • 2. dorsal/posterior primary ramus • Ventral/anterior ramus: it is the ventral division of spinal nerve outside the vertebrae, which supplies to the skin, muscles on anterior body. • Dorsal division supplies to the skin and muscles of the back.
  • 10. RTDCB • Brachial plexus comprises of Root, Trunk, Division, Cord and peripheral Branches. • A mnemonic for remember the region of the brachial plexus is: • Real - Roots • Teenagers - Trunks • Drink - Divisions • Cold - Cords • Beer – Branches
  • 12. Anatomy of RTDCB • Roots: (lying between the anterior and middle scalene muscles), • Trunks: (found in the posterior triangle of the neck), • Divisions: (lay posterior/behind the clavicle), Cords: (found in axilla & named according to their relationship with axillary/brachial artery ) & • Branches: (the five main nerve fibers in the arm).
  • 14. Formation of Roots & Trunk of the Brachial Plexus The roots of the brachial plexus come from branches of the spinal vertebrae C5-8 and T1. The cervical roots, C5 and C6, fuse together to form the Upper (Superior) trunk The cervical root C7 goes on to become the Middle trunk The cervical roots, C8 and T1, fuse together to form the Lower (Inferior) trunk
  • 15. The Trunks & Divisions of the Brachial Plexus • There are three trunks of the brachial plexus that lie in the posterior neck triangle. • Each of the Trunks has its two divisions • Anterior Division • Posterior Division • (Anterior divisions of the upper, middle, and lower trunks • Posterior divisions of the upper, middle, and lower trunks) • These six Divisions further unite to form the Cords.
  • 16. The Divisions & Cords of the Brachial Plexus • There are two divisions of the brachial plexus that lie posterior to the clavicle. These divisions go on to form the cords of the brachial plexus. • Anterior divisions of Upper and Middle Trunks go on to form the Lateral cord • All Posterior divisions go on to form the Posterior cord • The Anterior division of the Lower Trunk goes on to form the Medial Cord
  • 17. The Cords and main Terminal (Peripheral) branches of Brachial Plexus • The cords of the brachial plexus divide and join together to form the five main nerve branches of the arm. • The Lateral cord divides to become the Musculocutaneous and Median Nerve Branches. • The Medial cord divides to become the Median and Ulnar Nerve Branches • The Posterior cord divides to become the Radial and Axillary Nerve Branches
  • 18. Branches from direct roots • Dorsal scapular nerve-(c4-c5)- (levator scapulae, rhomboids) • Subclavian nerve(c5-c6)- (subclavian muscle • Long thoracic nerve(c5-c7)- serratus anterior muscle • Branch from trunk • Supra scapular nerve(c5-c6)- branch from upper trunk. • Supplies infra/supraspinatus
  • 19. Branches and their Roots • There are five "terminal" branches and numerous other "pre-terminal" or "collateral" branches that leave the plexus at various points along its length. • Lateral cord-1) musculocutaneous nerve(c5-c7) 2) lateral head of median nerve(c5-c7) • Medial cord-1) med.ant.thoracic nerve(c8-T1) 2) med. Cut. Nerve of arm(c8-T1) 3) med.cut. Nerve of forearm(c8-T1) 4) ulnar nerve(c7-T1) 5) med. Head of median nerve(c8-T1) • Posterior cord- 1) subscapular nerve(upper, lower)(c5-c7) 2) thoraco dorsal nerve(c5-c7) 3) axillary nerve(c5-c6) 4) radial nerve(c5-c8)